New AF TCCET Teams and Mission Creep Defined.

[DA SWO]

Let me add.
I like if it reduces the PJ load; my question is why is this AMC and not ACC/AFSOC (manning?)
Will they embed with the ERQS? and a manning decision gets made at launch (medevac=TCCAT) PR/Under fire=PJ)?
It would be interesting to see if this added requirement suddenly became part of the CSAR-X RFP. The HH-47 could suddenly reappear.

 

[amlove21]

Im going to respond by the numbers, not aggressively, just- pointedly. :-"

1- If they aren t trained to treat casualties under fire, they why are they being marketed as "point of injury tactical medical teams"? Thats disingenuous at best.

2- Why in the world would I deliver a patient to another helo borne asset when I could just take them to the hospital? I am not going to transload when I can just deliver to an actual definitive care facility. And please, save the extremely specific, non-theater scenarios (soooo, youre out in the middle of nowhere, and there is a mascas, and you have to quick turn, like 100 patients, and you cant fly all the way....). It't not the war we are fighting now, and it's most likely not the next one either. I can "what if" scenarios that lead down all sorts of roads- but that doesnt mean that crap is going to happen.

3- So, again, I am not transloading. I dont care if some 68W bird has an anesthesiologist on it. Cause you know what else that bird has? Zero power thanks to their 600lbs worth of dude and 1000lbs worth of equipment. They wont be able to take my 5 patients anyway. And since they have docs and nurses, why they hell would they keep the emt-b/68w? And now I raise the question- "Since the TCCET wont have dedicated iron (their own aircraft), how is THAT conversation going to go with the experienced combat medic they are effectively kicking off?" I will tell you how it would go with me or my team. Short answer is "Not well."

4- I think I hit this in 2, but I will say it again- I am in the fight until I hand over at the hospital. Everyone is coming off target and getting treated. Telling me that I have some other air asset that we are going to put at risk for a situation that is already in the crapper only risks more Americans, it does not "get the PJ team back into the fight faster".

5- Lets call a spade a spade here. A doctor, nurse, and anesthetist with 10 weeks training and some nifty multicams are not tactical. It's bordering on lying, and god forbid they actually get a mission that actually requires some sort of tactics.

Because you know what's going to happen then? They're going to have to call another PJ team out, and put THEM in harms way.

 

[HealwithSteel1]

Let me add.
I like if it reduces the PJ load; my question is why is this AMC and not ACC/AFSOC (manning?)
Will they embed with the ERQS? and a manning decision gets made at launch (medevac=TCCAT) PR/Under fire=PJ)?
It would be interesting to see if this added requirement suddenly became part of the CSAR-X RFP. The HH-47 could suddenly reappear.

Good stuff. Medical UTCs get manned from all the commands. AMC is the command tasked to develop patient movement medical capabilty, so it makes sense that the USAF/SG would direct AMC to develop TCCET. Keep in mind, while they can support the ERQS, the TCCET was designed to support MEDEVAC missions. CSARMEs in ACC and SOFME/SOCCETs in AFSOC already do this mission in support of the GAWS so TCCET will support MEDEVAC units most commonly.

 

[policemedic]

I think a lot of the controversy stems from the passages I've highlighted below. Setting aside the fact that Iddins and McCarthy are (in my view) deliberately misrepresenting the capabilities of both conventional and SOF medical assets in theater, their quotes make it clear that they envision TCCETs receiving patients on the battlefield. I understand that may not be accurate, as HealwithSteel1 has stated. However, point of injury care is what they're purporting to provide.

If TCCETs are designed to provide a critical care interfacility evacuation asset, their personnel mix and capabilities make sense. But that's not what a Brigadier General and the Major in charge of their training are saying.

By Markeshia Ricks - Staff writer
Posted : Saturday Jun 2, 2012 10:00:02 EDT
The U.S. military is enjoying the highest casualty survival rate in the history of modern warfare, but medical officials believe they can save even more lives by getting advanced care sooner to injured troops.
For nearly a year, a three-member team of Air Force health professionals has successfully evacuated and treated 299 severely wounded troops by taking the emergency department to the injured, and another team is set to stand up in the coming month.
Known as tactical critical care evacuation teams, or TCCET, the teams comprise an emergency medicine or critical care physician, a certified nurse anesthetist and an emergency department nurse or intensive care/critical care nurse. The teams specialize in moving and treating patients who have just been injured and risk dying if emergency treatment isn’t administered immediately.


Finding a way to provide more advanced care at the point of injury will provide a missing piece of the complex puzzle that is war-related trauma treatment.
The new tactical teams, which will fly most movement missions on rotary wing aircraft such as a Black Hawk helicopter, are equipped and trained to start trauma resuscitation treatment immediately after injury. according to Iddins.
That kind of aggressive treatment saves lives, Iddins said, but is beyond the scope of traditional pre-hospital tactical casualty evacuation capabilities. “TCCET is designed to bring a higher level of medical care directly to the casualty, specifically at the point of injury, in order to initiate emergency department/trauma department-level control resuscitation earlier and more aggressively than has traditionally occurred.”


Maj. Michael McCarthy, deputy director at the Center for the Sustainment of Trauma and Readiness Skills in Cincinnati, said that though members of the new tactical teams can conduct a CCATT mission, the teams are specifically trained to deliver high-level, critical care in the tight spaces of a helicopter with limited supplies. Unlike CCATT members, tactical care team members also are trained in combat survival.

 

[Johca]

Suggesting TCCET is supporting the aeromedical capability is misrepresenting as the capability as described in the AFT article is better stated as enhancing aeromedical capability.

Enhancing is even somewhat misinforming as the article clearly infer the concept of operations is mission creeping into Echelon 1 trauma care to stabilize patient for movement to the higher or next level of support with the mixing in of “care under fire” and “combat casualty evacuation”.

The capability being developed cannot be spun any other way.

See recruitment video http://www.youtube.com/watch?v=2AQ65I9FUPA

Aeromedical Evacuation the Air Force provides is the movement of stabilized causalities and patients who are prepared for airlift transportation from the forward airfields in the combat zone to other medical elements in the theater of operations. Patient movement is planned, coordinated and scheduled through Aeromedical Evacuation Coordination Center (AECC)/Theater Patient Movement Requirements Center.

This TCCET capability will be more operationally connected to mission tasking through the Air Operations Center as it will be a not scheduled tactical medical response. Please explain how it will not be as immediate response to the tactical location in an active combat zone. This will require flying through tactical airspace over and around the active combat zone. Consequently the mission is not aeromedical evacuation, but actually battlefield casualty surgery at the echelon 1 and echelon 2 level. Meaning the capability is expected to be survivable and effective in doing surgery at the battalion aid station level or on the battlefield as the commercial depicts.

The Air Force Medical Services has had an identity crisis ever since it established itself separate from the Army with the rest of the Air Force back in 1947. Congress never had intent of the Air Force also establishing a ground battlefield medical service in competition with Army and Navy Medical Services which has line (nonmedical) unit duty assignments and more specifically what is called combat medics.

Flight Surgeons have had a hair up their ass as they became more and more unimportant in the MTFs as they hid in their Flight Medicine fiefdoms with their 4F (flunky) aeromedical medics avoiding being a equal care provider capability with emergency medicine and family medicine clinics and more importantly the surgery rooms. Don’t get me wrong there were some good Flight Surgeons but the numbers of incompetent and lazy flight surgeons hating playing mobility games and being deployed was not unnoticeable in 1993 and 1994 and its not unnoticeable now when I visit the MTF and overhear conversations which BTW I overhear off base too. The Physician comes in as a Captain and all you hear the Captains do is bitch and complain about deployments and military exercises.

However and regardless of the not really wanting to be a military DOC in a MTF, the establishment of the Squadron Medical Elements and air transportable hospitals was more about Air Force Medical Service getting more budget clout equal to the Army and Navy’s medical service more than getting more timely effective and efficient care to the battlefield casualty. The same can be said about TCCET now that aeromedical evacuation is not dedicated aeromedical airlift but joint utilization airlift that becomes aeromedical airlift when needed.

My stronger concern however is with suggestions these tactical teams will fly most movement missions on rotary wing helicopters such as Black hawk helicopter. It isn’t the having this capability available on helicopters that concerns me, it is the potential collateral airframe acquisition impact such belief much more lives saved brings with it.

The AFT article statistics of lives saved is misleading pertinent to IEDs. These devices kill, but the blast trauma is such that survivability is mostly luck of what the shock wave, blast wave, shrapnel, burning heat did or didn’t do and subsequently how quickly the bleeding is stopped. The helicopter or fixed wing evacuation still has travel time involved in getting to the victims. With speed of getting cvapability there the more suitable airlift is a V-22 capability more than a helicopter capability. The V-22 also strongly favors the rapid response capability security forces wants for its missile field patrols and its convoy movements of the missiles and it 820th SFS rapid response air assault capability. Thus the acquisition politics will favor satisfying the common denominator more than getting the aircraft weapon system needed to go into hot LZ to execute combat rescue.
The HH-60 cabin area is unsuitable for CSAR (internal fuel bladders in cabin) and even more unsuitable to being a surgical suite. More mission impairing is getting a suitable replacement CSAR helicopter will now be competing with tactical aeromedical mission needs and common vertical lift support program (CVLSP). As the CVLSP gets more horse power from aeromedical throwing its influence into the mix, units like the 820th SFG will develop and putting in their air assault concepts of operations into the CVLSP requirements mix (yep everybody can now be a PJ without getting adequately trained and qualified, that’s what happens when quitters and failure to train members are classified into medical and security forces).

The AFT article discloses “evacuated and treated 299 severely wounded troops by taking the emergency department to the injured”, but post 11 in this conversation discloses the spin put on this number.

Regardless the TCCET surgical capability on the helicopter must be capable of providing a sterile surgery room environment. Most difficult on anything less than a heavy lift helicopter (H-47, H-43). The H-60 lacks the suitable surgical room configured cabin and lift capacity especially at terrain elevations above 10,000 feet above sea level.

I certainly get a chuckle from Air Mobility Command surgeon Brig. Gen. (Dr.) Bart Iddins’ implied or hidden assertion “Many of the casualties of Operation Enduring Freedom suffer blast-related injuries such as burns, lung trauma, traumatic amputation, blunt force trauma and head injuries”.

IEDs critically injure and kill, but the blast trauma is generally such that survivability is mostly luck of what the shock wave, blast wave, shrapnel, burning heat did or didn’t do and subsequently how quickly the bleeding is stopped. Consequently is the combat lifesaver trained solider, sailor, airman trained and qualified in the tactical unit or convoy giving immediate response tactical combat casualty treatment that is actually increasing survivability numbers available for the TCCET to be a difference.

Blast trauma typically produces moderate to severe traumatic brain injury and moderate to severe pulmonary contusion and significant penetrating shrapnel and penetrating debris projectile trauma to torso. This certainly-so requires a significant surgical capability. Having this capability also means equipment and consumables such as oxygen, anesthesia, drugs, and many pints of whole blood to be putting on a helicopter or fixed wing aircraft.

On the helicopter going into the hot landing zone this means a lot of equipment and consumables are exposed to be hot at with small arms, RPG, and man packable shoulder launched missiles. Nowhere in the TCCET marketing is there discussed what happens when a round or RPG hits the pressurized oxygen and anesthesia gas cylinders. Nowhere in the TCCET marketing is the basic concern existing since WWII of placement of physician in combat aircrew tactical operational risk of getting KIA or WIA to save a few impairs the hospitals ability to treat the many (“risk a critical item-the medical officer for a very questionable gain.” Tactical utility of physician is militarily unacceptable.”—not my words, but words prevalent in commander level discussions.)

This by the way is why the Air Force removed Parachute qualified Physicians from the PJ teams in 1949 along with Geneva Conventions of 1949 reasons. Since 1950 physician and nurse wartime service is being noncombatant military and this is why until SMEs were established the Air Force Medical Services lacked line unit assignments.

Anyhow the TCCET will be one significant funded Physician, Nurse, Physician Assistant, and enlisted med tech manpower bucket to fill and sustain at the expense of the MTFs and SMEs.

 

[amlove21]

So a question for those PJ's on here: what would be your preference were you to be suddenly promoted to the top of the AFSOC chain? How would you want the allocation of PJ's and their mission focus/training to go in light of units like this being stood up, the winding down of theaters of the GWOT, etc? I've seen a few things on here as to a general idea of what you'd like but wanted to hear some specific stuff you guys had in mind.

Null question. Most of the PJ's in the AF (vast majority) are in ACC. And a CRO will never, ever, everevereverever be at the top of the chain in AMC. Pilot's AF my friend.

Good question, maybe for another thread. Im too short in the tooth to posit an answer.

 

[JohnnyBoyUSMC]

Null question. Most of the PJ's in the AF (vast majority) are in ACC. And a CRO will never, ever, everevereverever be at the top of the chain in AMC. Pilot's AF my friend.

Good question, maybe for another thread. Im too short in the tooth to posit an answer.

GTG. Well wasn't saying I was expecting a PJ to end up at the top of a pilot's AF, was more like wondering how you guys would run it in a hypothetical. Also, sent a PM, know your busy but wasn't sure if it made it through.

 

[Johca]

Going further, this sounds like Medevac on steroids.... which is something I've heard that PJ's don't do, you don't do casevac or medevac, you do personnel and equipment recovery.

Medevac is not the PJ mission utility purpose. Care under fire, tactical emergency trauma field care and combat casualty evacuation is a mission utility purpose, but not as an enhanced medevac or permanently support sick call squad.

The medical capability utility is unchanged from WWII in that the capability is to have survivability and function during unmounted (on-foot) overland travel movement of survivors and survivors having injuries needing treatment during this movement.

The combat care under fire support to Army (primarily) but also marine Infantry has most concern with the initial assault phase particularly during the lines of movement into the assault drop zone or assault air field in enemy controlled or occupied territory.

Although the most acknowledged beginning of Pararescue are the parachute missions done in the China-Burma-India (CBI) area of operations during WWII there are other contributing to capability developing missions done in the North Africa- Mediterranean area of operations, specifically parachute team activities of Air Rescue Unit 1 doing rescues of aircrews downed in Yugoslavia and other distant areas of eastern Europe.

After WWII the cold war reconnaissance activities of reconnaissance aircraft, extreme high altitude renaissance balloons, reconnaissance satellites and eventually unmanned drones (now called UAVs) resulted in the quick by 1949 enhancement of utility to do materiel recovery.

So a question for those PJ's on here: what would be your preference were you to be suddenly promoted to the top of the AFSOC chain?

Just to be a wise guy with tongue in cheek, when were PJs not at the top of the AFSOC chain? Air Force Pararescue team and career field capability and mission utilization go back to 1947 before there was CTT (1953) or SOW (1963) and TACP providing the capability it has now grown-up into providing since 1977. PJs as a career field and a tactical capability were top of the capability provided chain before AFSOC and USSOCOM existed.

Digging through the official archives will lead to discovery of “In March 1952, an additional responsibility was given to the Air Resupply and Communications Service when all formal escape and evasion training in MATS was transferred to it from the Air Rescue Service.” Further digging will find that although the PJs were assigned to Rescue units they were flying on “Black” helicopters and fixed wing aircraft flown by other units/agencies during the Korean War just as they did in Laos and Cambodia during the Southeast Asia conflicts. They were doing a bit more than just being medics on those aircraft- http://usafhpa.org/581stARCS/581starcs.html-as the mission was bit more than rescue of downed aircrew http://usafhpa.org/581stARCS/581starcs.html. Further digging into the archives reveals a lot of PJ mission use on “black” aircraft.

Pararescue utilized to provide combat medical coverage for two airborne assault operations done by the 187th Airborne Regimental Combat Team (RCT). On 20 October 1950 paratroopers of the 187th RTC airdropped at Sukchon-Sunchon located approximately twenty miles north of P'ycogyang, the capital of North Korea. On 23 March 1951 paratroopers of the 187th RTC airdropped at Munsan-ni located north of Seoul between the Han and Imjin Rivers. A three man pararescue element inserted by helicopter as part of a reception party on the Munsan-ni drop zone prior to the airdrop. No CCT or TACP there.

There are other interesting Pararescue utility finds such as: “The case for parachute landing of materiel and personnel as opposed to glider and air landing”, by Lt Col L. D. Buttolph, Command and General staff College.31 May 49. http://cgsc.cdmhost.com/cdm/singleitem/collection/p124201coll2/id/204/rec/163
Page 9:
“e. Landing in airheads. Paratroops can jump and materiels be dropped anywhere, if the rate of loss will be accepted. This is proven by the U. S.A. F. Pararescue teams now in service, and the parachutist forest rangers who use this method for rapid transportation into isolated areas to fight forest fires.

Difficult terrain, either due to natural or man-made obstacles, will not eliminate parachute operations. In fact, it may be of assistance, as parachutists can assault any area within plane radius distance and therefore cause the enemy to disperse his forces. They can also use the surprise element to advantage by dropping on less desirable terrain where the enemy will not be expecting, or be prepared, for combat operation. In most, if not all airborne operations where the enemy is prepared, parachutists must be in the first assault to seize and secure landing strips for air-landed troops.

The context being PJs can hold their own along side all the other AFSOC top of the chain capabilities and there is no promoted to considering the mission tasked to do and mission accomplished history going back as an Air Force career field and a tactical team capability to 1947.

 

[JohnnyBoyUSMC]

Just to be a wise guy with tongue in cheek, when were PJs not at the top of the AFSOC chain?

LOL, that was a tongue in cheek mistake on my part, meant top of AF command total. As far as the top of AFSOC, I don't wanna go getting any CCT or SWOT guys angry at me so I'll leave that opinion piece alone. The Corps despite what other may think did teach me humility

 

[HealwithSteel1]

I think a lot of the controversy stems from the passages I've highlighted below. Setting aside the fact that Iddins and McCarthy are (in my view) deliberately misrepresenting the capabilities of both conventional and SOF medical assets in theater, their quotes make it clear that they envision TCCETs receiving patients on the battlefield. I understand that may not be accurate, as HealwithSteel1 has stated. However, point of injury care is what they're purporting to provide.

If TCCETs are designed to provide a critical care interfacility evacuation asset, their personnel mix and capabilities make sense. But that's not what a Brigadier General and the Major in charge of their training are saying.

PoliceMedic,
I understand why you highlighted those points as a source of contention. Words and definitions matter. The TCCET goes to POI in support of MEDEVAC missions for appropriate patients consistent with the utilization of the Army’s Enroute Critical Care Nurse (ECCN) capability. The MEDEVAC casualty on-load location is considered “POI” in the Enroute Care lexicon. Obviously, immediately means as soon as the airframe can get to the site. TCCET is a non-First Responder. They are not trained as combatant medics or as rescue specialist (PJ). They are delivered to the casualty by a MEDEVAC platform and can immediately begin casualty care.

TCCC employed by skilled PJ/ATP/combat medics has had a huge impact in saving lives that would have died on prior battlefields. If the conventional medical forces are to fully capitalize on the hard won TCCC saves, it has to get trauma room level care to them sooner. That is what the TCCET’s mission is. On the second line of the article, they sum it up very well saying “…taking the Emergency department to the injured…” The TCCET is designed to bring the capabilities of the trauma room forward so trauma care can begin as soon as possible. TCCET is less about moving patients as providing trauma or ICU medical care while the “room” is being moved. The 50% potentially survivable that died of wounds article (Google “Eastridge Died of Wounds on the Battlefield”) assumed that the Role 3 was close to the casualty. The TCCET moves at least part of it (the ER) closer to the casualty.

This is similar to the British MERT concept as pointed out by JustAnotherJ. The concept works as MERT patients spend about 30 minutes less in the ER prior to surgery because much of the trauma workup has been done enroute. There are a number of statements in the article that describe the “mobile ER” concept (“…are equipped and trained to start trauma resuscitation treatment …in the tight confines of a helicopter with very little equipment.” “…initiate emergency department/trauma department-level control resuscitation earlier and more aggressively than has traditionally occurred”, etc). As a surgeon, if the TCCET delivers casualties ready to go to the OR sooner, I see the improved chance of survival as a huge win for all of us.

 

[amlove21]

Just to be a wise guy with tongue in cheek, when were PJs not at the top of the AFSOC chain.....

I wont speak for him, but I think he meant, "what if a PJ (CRO) was in charge of AFSOC, and you could dictate your own path". At least, that's how I read it. And that's never going to happen. A CRO with 2-3 stars?

 

[JohnnyBoyUSMC]

I wont speak for him, but I think he meant, "what if a PJ (CRO) was in charge of AFSOC, and you could dictate your own path". At least, that's how I read it. And that's never going to happen. A CRO with 2-3 stars?

Yea that's pretty accurate as to what I meant, and didn't figure it was gonna happen, was meant as a "if you suddenly had God-level command power I.E. pentagon level, how would you dictate the direction of the PJ community as a whole mission wise."

 

[Johca]

PoliceMedic,
As a surgeon, if the TCCET delivers casualties ready to go to the OR sooner, I see the improved chance of survival as a huge win for all of us.

Agree 100%, but to the operating room located where?

No mention in TCCET concept of operations is there mention of moving the functioning surgical capability with surgical team ready to perform surgery to echelon 1 tactical environment while transporting to echelon 2 or higher operating room capability.

Echelon 2 is the battalion aid station, medical company forward surgical capability, Division Clearing station.

Echelon 3 is the operating room capability found in the MASH and air transportable hospitals. The MASH and air transportable hospital is expected to provide immediate surgical treatment and post-operative care.

Echelon 4 is essentially a major military regional hospital having the additional capability to provide rehabilitation and reconditioning during the healing process.

Echelon 5 is definitive care in a military medical treatment facility located in the Continental United States.


http://www.youtube.com/watch?v=mFXxiDyxCCo clearly states the gap being filled is delivery from forward surgical capability-Echelon 2 Battalion aid stations and medical companies to Echelon 3 in area of operations operating room capability. Unfortunately the AFT article suggests and implies a future something much different capability. Most of the helicopter TCCET patient stabilization and preparation wasn’t on the helicopter. Nothing much different than was being done during CASEVAC or MEDEVAC on Air Force helicopters during the Korean War. ecept it is disclosed the Captain likes flashing the helicopter crew. She can flash me anytime BTW.


Fixed wing and helicopter TCCET mission profiles differ considerably.

The moving forward of the trauma surgical center on an aircraft brings with it a considerable support requirement. If any significant on the ground loitering in the forward tactical area happens for any reason a force protection requirement begins to raise its ugly head.


The vertical airlift capability suitable for a functioning TCCET operating capability in flight is a heavy lift helicopter (H-47, H-53) and or the V-22.

Fixed wing operations is complicated by the potential FOD on landing or taxi damage to an engine and the fact any escort provided for rescue purpose of a long distance fixed wing mission profile and if going into an airstrip of convenience to include a road (essentially the C-130, C-141, C-5 SOLL I and SOLL II mission profile of the 1980s) a CCT will be needed on the ground in addition to force protection for the aircraft and crew and physician, nurses, etc.

Fixed wing capability is hampered by finding a suitable and convenient place to land (unless there is a parachute in capability not being disclosed). Then it’s a matter of transportation time and if CASEVAC helicopter to the closest MASH or air transportable hospitals is the fasted ready to go delivery of patient on to the surgical table in the Operating Room. It also begs the question of if the fixed wing TCCET is to bypass Echelon -3 (level -3) locations and deliver direct to the Echelon 4 capability such as found at Ramstein AB Germany.

 

[Johca]

At least, that's how I read it. And that's never going to happen. A CRO with 2-3 stars?

Which is why I prefaced with me being a wise guy with tongue in cheek. I was doing some poking in fun.

As far as a CRO getting promoted to 2 and 3 star levels in the future, it is both possible and probable and just a matter of time.

Here’s a few Air Force Flag Officer bios, I worked either directly with them or for them when they were Captains or Majors CCT (before STO) officers during my active duty career.

http://www.af.mil/information/bios/bio.asp?bioID=7878

http://www.af.mil/information/bios/bio.asp?bioID=8640

In one of the bios you will find--4. November 1983 - June 1986, Chief, Combat Control and Pararescue Division, Headquarters 23rd Air Force, Scott AFB, Ill. (November 1985 - June 1986, Commander, Pararescue Military Freefall Training Team) . Me thinks I recollect being one of the MFF instuctors in that team.

 

[DA SWO]

I wont speak for him, but I think he meant, "what if a PJ (CRO) was in charge of AFSOC, and you could dictate your own path". At least, that's how I read it. And that's never going to happen. A CRO with 2-3 stars?

AFSOC will have a ST Wing soon (24th SOW), that should pave the way for ST BG's, which means (in theory) a CRO could get there.

 

[Johca]

AFSOC will have a ST Wing soon (24th SOW), that should pave the way for ST BG's, which means (in theory) a CRO could get there.

Actually the career development needed to get to Flag rank has no requirement of a ST wing or rescue wing. The on the books CRO duty assignments fill the squares to get to O-6 and the path beyond is available if the CRO decides to go that path.

There is a CCT MSgt I worked with (both of us were MSgts) who is now an active duty Colonel and commanding an AETC Training Group at Lackland who could get promoted to BG if he stays around.There was a PJ to PA to CRO that made Colonel that could have gotten BG but he decided to retire as a Colonel after 30 years as he only had twenty years commissioned and he could have stayed around another 10.

Take a look at a few more bios and the assignment history of other than the two I posted, the flag officer is expected to be a bit more than just a pilot or STO or CRO as that level of command can be of AETC, Security Forces or whatever wing.

Here’s a bio of the recent former AFSOC/CC http://www.af.mil/information/bios/bio.asp?bioID=7672 He was my aircraft commander as a Captain on a few operational missions back in the 1970s and in fact he was getting his pilot qual at Hill AFB in 1974 at thesme time I was getting my initial enlisted aircrew qual as a PJ/gunner on the H-3 and H-53.

Here’s a bio of my squadron commander back in 1977 to 1979 http://www.af.mil/information/bios/bio.asp?bioID=4918

 

[HealwithSteel1]

Agree 100%, but to the operating room located where?

No mention in TCCET concept of operations is there mention of moving the functioning surgical capability with surgical team ready to perform surgery to echelon 1 tactical environment while transporting to echelon 2.

Johca,
While I know of three surgical capabilities that can work on an airframe as you suggest, the point is that TCCET reduces the time to the OR by doing trauma room work enroute. For each casualty, there are two golden hours: the first is to get them to the trauma room and a second to get them from the trauma room to the OR. In general, even with critically injured casualties, the average time in our deployed Trauma hospitals (Role 3) for ED to OR usually exceeds one hour. When enroute trauma room care like the TCCET is used, time in the ED is decreased 18 minutes for severely injured and 41 minutes for critically injured casualties.
That time saved in the ED trauma room by putting trauma capabilty into the prehospital movement translates to better surgical outcomes including survival.

 

[amlove21]

Johca,
...TCCET reduces the time to the OR by doing trauma room work enroute. ... When enroute trauma room care like the TCCET is used, time in the ED is decreased 18 minutes for severely injured and 41 minutes for critically injured casualties.
...

I would like to know where those numbers came from. Can you share your source? And what is the context? The TCCET gathered those numbers in what control? In response to what variant? Who reviewed those figures?

With the shift to goal-directed care and therapy, which is where the focus of our medical care is going, I would argue that the TCCET is not the owner of that information, nor it's sole purveyor. We (Pararescue teams) have ISTAT's, we have ETcO2, we have ultrasounds (for FAST's), and we understand and employ both damage control resus, goal directed therapy and treatment, and the preparation of injured for the operating room- not just the turn over.

I dont want to be confrontational, but extraordinary claims require extraordinary proof.

Last 3 posts...

As always, thank you for the inputs, Brother. Lots of stuff I had no understanding on/education in.

 

[surgicalcric]

...TCCET reduces the time to the OR by doing trauma room work enroute. ...That time saved in the ED trauma room by putting trauma capabilty into the prehospital movement translates to better surgical outcomes including survival.

What trauma room work are you referring to that a PJ/18D isn't capable of performing?

 

[TLDR20]

I'm curious as well what these guys bring on a short flight that I don't? Other than an awesome beard obviously.